Folliculitis Flashcards
Definition
Dermatological condition characterised by inflammation of the hair follicle
Risk factors
- Trauma: shaving, hair extraction
- Topical corticosteroid use
- Diabetes Mellitus: impaired cellular immunity
- Immunosupression: eosinophilic folliculitis
- Drug-induced:
= corticosteroids
= androgenic hormones
= isoniazid
= lithium - hot-tub use: ‘hot-tub folliculitis’ caused by pseudomonas aeruginosa
- chronic inflammatory skin disease: licken planus, discoid lupus erythematosus
Aetiology
- Infectious or noninfectious causes and results in the formation of erythematous papules and pustules.
Infectious causes: - bacterial:
= MC folliculitis is Staphylococcus aureus
= Pseudomonas aeruginosa
= Klebsiella
= Proteus - fungal
- viral
= HSV1/2
Signs
- Localised to shaving area
- Blistering: if severe
- Subdermal mass: abscess formation if can occur in severe disease
- Raised eosinophils: eosinophilic folliculitis
Symptoms
- Erythema
- Papules: small, clusters
- Pustules: small, white-headed
- Pruritus: localised to affected area
Diagnosis
Uncomplicated = clinical diagnosis
Consider:
- Bacterial skin swab: gram-positive cocci in Staph Aureus
- Viral skin swab: moulding and clustering of keratinocytes is suggestive of HSV
- Skin scraping for mycology: hyphal forms seen in dermatophyte infection
- Skin biopsy: neutrophillic infiltrate in bacterial and fungal disease, lymphocytic in viral
Treatment
Conservative:
- Using clean, sterile razors for shaving
- Wearing loose clothing
- Avoiding hot-tub use
- Antibacterial soap use
Medical:
- Mild: self limiting
- Mod (bacterial): oral flucloxacillin (Staph Aureus), oral ciprofloxacin (Pseudomonas spp.)
- Mod (viral): Oral Aciclovir
- Mod (fungal): ketoconazole, fluconazole, itraconazole
Surgical (severe):
- Incision and drainage
- IV Abx
Complications
Abscess formation: in severe infection
Sepsis
Scarring
